Provider Demographics
NPI:1023819307
Name:MARSH, JANEEN
Entity type:Individual
Prefix:
First Name:JANEEN
Middle Name:
Last Name:MARSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3634 SW 86TH RD
Mailing Address - Street 2:
Mailing Address - City:CLATONIA
Mailing Address - State:NE
Mailing Address - Zip Code:68328-8464
Mailing Address - Country:US
Mailing Address - Phone:402-314-3080
Mailing Address - Fax:
Practice Address - Street 1:3634 SW 86TH RD
Practice Address - Street 2:
Practice Address - City:CLATONIA
Practice Address - State:NE
Practice Address - Zip Code:68328-8464
Practice Address - Country:US
Practice Address - Phone:402-314-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17743164W00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No164W00000XNursing Service ProvidersLicensed Practical Nurse